UPDATE: OHA Requests Comments on Proposed GEMT State Plan Amendment
Posted: June 30, 2017 (updated July 14, 2017)
Comments due: 5pm Friday, August 4, 2017
The Oregon Health Authority (OHA) posted a public notice calling for comments on its plan
to propose an amendment to the State Medicaid Plan to implement a supplemental payment program for ground emergency medical transportation (GEMT), as required under House Bill 4030 of the 2016
The full public notice of the request for comments, which outlines their proposed approach, and a link to the draft amendment are available at:
Contact: Jesse Anderson, OHA/State Plan manager
GEMT & House Bill 4030:
An Opportunity to Help Oregon’s Public EMS System
Today, more than 1 million Oregonians receive care through the Oregon Health Plan (OHP), Oregon’s Medicaid program. The Oregon Health Authority reports that since the Medicaid enrollment expansion in January 2014, approximately 436,000 Oregonians have gained coverage, a 71 percent increase since 2013.
Uncompensated Costs of
Transporting Medicaid Patients
Like all Oregonians, Medicaid patients rely on Oregon’s EMS system when they need emergency medical care and transport to a medical facility. The reimbursement rate for the care and transport of Medicaid patients is far below the cost of providing these services, placing an increasingly greater financial burden on the Public EMS system, and ultimately taxpayers.
GEMT draws funds from the federally-backed Medicaid entitlement program, allowing public EMS providers the ability to collect a percentage of their uncompensated costs for providing care to Medicaid patients. This would assist Oregon’s public EMS system by ‘filling the gap’ in the cost of these services now being shouldered by local fire departments and districts.
GEMT legislation (HB 4030) was the first step to engaging stakeholders
GEMT legislation (like that passed in California and Washington) was required for Oregon’s public EMS providers to be eligible for federal reimbursement. Enacted in March 2016, House Bill 4030 allows Oregon’s EMS system to work with the State on the creation of a State Amendment Plan (SPA).